Types of centredness in health care: themes and concepts

Abstract

Background For a variety of sociological reasons, different types of centredness have become important in health and social care. In trying to characterize one type of centredness, we were led to consider, at a conceptual level, the importance of the notion of centredness in general and the reasons for there being different types of centeredness. Method We searched the literature for papers on client-, family-, patient-, person- and relationship- centred care. We identified reviews or papers that defined or discussed the notions at a conceptual level. The reviews and papers were analyzed as text transcripts. Results We identified 10 themes that were common to all the types of centredness. At a conceptual level we could not identify thematic differences between the types of centredness. These findings were subjected to a philosophical critique using ideas derived from Wittgenstein. Conclusion Different types of centredness are required in different contexts. The differences are justified by their practical utility. The unifying themes of centredness, however, reflect a movement in favour of increasing the social, psychological, cultural and ethical sensitivity of our human encounters.

Notes

Acknowledgements

This paper stems from a research project entitled ‘Improving patient-centred care for people with dementia in medical encounters’, which was funded by the BUPA Foundation. We acknowledge this support with thanks, as well as the encouragement of our collaborators: Dr Ruth Briel, Dr Eileen Kaner, Dr Louise Robinson, Professor John Spencer and Dr Paula Whitty. We are also grateful to the journal’s reviewers for their comments.